Pleuroparenchymal fibroelastosis after hematopoietic stem cell transplantation in children: a propensity score-matched analysis
- Authors
- Oh, Sae-lin; Lee, Ji Won; Yoo, So-Young; Kim, Ji Hye; Kim, Yu Jin; Han, Joungho; Kim, Kyunga; Kim, Jihyun; Jeon, Tae Yeon
- Issue Date
- Mar-2023
- Publisher
- Springer Verlag
- Keywords
- Pulmonary fibrosis; Hematopoietic stem cell transplantation; Pediatrics
- Citation
- European Radiology, v.33, no.3, pp 2266 - 2276
- Pages
- 11
- Indexed
- SCIE
SCOPUS
- Journal Title
- European Radiology
- Volume
- 33
- Number
- 3
- Start Page
- 2266
- End Page
- 2276
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/61876
- DOI
- 10.1007/s00330-022-09188-2
- ISSN
- 0938-7994
1432-1084
- Abstract
- Objectives
To investigate the incidence, risk factors, and clinical outcomes of pleuroparenchymal fibroelastosis (PPFE) in pediatric hematopoietic stem cell transplantation (HSCT) recipients.
Methods
This single-center, retrospective, case-control study included 738 consecutive patients who underwent chest CT more than 3 months after HSCT. We identified patients who fulfilled the diagnostic criteria for PPFE and assessed their clinical characteristics and radiologic findings. Propensity score–matched analysis was performed using four covariates (age, sex, HSCT type, and primary disease). The risk factors and clinical outcomes of PPFE were analyzed using the Fine and Gray regression model and stratified log-rank test in the matched groups.
Results
PPFE was identified in 4% (31/738, 8.3 ± 3.1 years, 15 males) of the pediatric HSCT recipients with a median time of 2.7 years after HSCT, and it occurred following allogeneic (5%, 15/317), autologous (4%, 15/379), or both (2%, 1/42). Matching yielded 30 and 130 cases in the PPFE and control groups, respectively. The PPFE group showed more frequent late-onset noninfectious pulmonary complications (LONIPCs) and pneumonia more than 3 months after HSCT (p < 0.05). Multivariable analysis showed a significantly higher risk of PPFE in HSCT recipients who had pneumonia more than 3 months after HSCT (hazard ratio = 10.78 [95% confidence interval: 4.29, 27.13], p < 0.001). The PPFE group showed higher mortality (73%, 22/30) and poorer median overall survival (6.8 years [95% confidence interval: 4.1, 9.5]) than the control group (p < 0.001).
Conclusions
PPFE represents a severe type of LONIPC after HSCT. HSCT recipients with pneumonia after HSCT may have an increased risk of PPFE.
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Collections - 2. Clinical Science > Department of Radiology > 1. Journal Articles
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